The Seattle & King County Public Health page called "HIV/AIDS Program: How effective are condoms?" reports:
No method of contraception or disease prevention is effective when practiced incorrectly or inconsistently. A 1988 National Survey of Family Growth found abstinence to have a contraceptive failure rate of 26% when not practiced consistently. So, in abstinence, as in condom use, consistency is key.
Mighty odd-sounding, as OpinionJournal reported: Is it really abstinence when you aren't consistently abstaining? Or is their claim that people who decide to be abstinent nonetheless in practice end up backsliding — and often enough that they get pregnant in 26% of the first year in which they chose to be abstinent? (That's how contraceptive failure rates are generally measured.) If that's so, then that would suggest that abstinence decisions, at least unless reinforced by some belief system that will deepen the commitment to the decision, are remarkably ineffective.
But here's what's really going on: (1) a confusing term being used by public health scholars, which (2) likely led to confusion on the part of the person writing the Web page, which (3) translates into false claims being passed along to the public. If you look at abstracts of the 1988 Survey, you find that 26% is the failure rate for "periodic abstinence", which means "rhythm and natural family planning."
That's right: 26% is the failure rate for the rhythm method, not for deliberate decisions to abstain. Public health scholars apparently refer to the rhythm method and similar practices as "periodic abstinence," which is literally accurate, but potentially confusing to nonexperts, since it's close to a term ("abstinence") that means something quite different in lay discussion. The Web page author seemed to have been confused, interpreting "periodic abstinence" simply as "inconsistently practiced abstinence," and thus labeling it simply as "abstinence." And readers will therefore be getting false information: "Abstinence" in lay discussion generally refers to a deliberate decision not to have sex at all — rather than just to a decision to have sex only on one's presumably less fertile days — so people will read the claim as pointing to the dangers of abstinence, rather than the dangers of the rhythm method.
So three tips: (1) If you're a scholar, especially in a discipline where laypeople or nonacademic public policy analysts might consume your output, try to avoid adopting terms that may confuse outsiders. (I realize that sometimes there may have to be trade-offs between clarity to outsiders and clarity or convenience to fellow scholars, hence my use of "try.") Lawyers and judges, by the way, are frequent offenders here, creating legal terms that sound like one thing in English (e.g., "actual malice" in libel) but mean something quite different in legalese. This is especially dangerous in law, where the lay public is especially likely to be interested in the information, though also especially hard to root out, since many of these terms evolve over decades, and are hard to clarify because of the weight of precedent and tradition.
(2) If you're consuming academic works, be on the lookout for terms that don't mean quite what they seem to mean at first, and for qualifiers that are sometimes overlooked but are tremendously important. There are false friends in translation from technical English into lay English just as there are in translation between languages.
(3) Don't believe everything you read.
The "rhythm method" is not the same thing as "natural family planning." As the Couple to Couple League explains:
Those who are interested can read more about NFP here.
Moreover, NFP is highly effective when it is done properly.
This is a good example, however, of how a law professor can develop a lecture even from a ham sandwich.
The 87% effectiveness rate to which you refer is for one NFP method at "typical use," rather than "perfect use." If you're going to be critical of NFP and my comment at least have the courtesy to place things in their proper context.
So that this doesn't happen again, here's the relevant information:
Here's a look at the effectiveness rates of the different methods of natural family planning. Effectiveness rates are available for all methods except cervical position and dilation.
Eugene says:
"Is it really abstinence when you aren't consistently abstaining? Or is their claim that people who decide to be abstinent nonetheless in practice end up backsliding..."
Still, I hear that backsliding is less likely to get you pregnant than frontsliding...
;-)
Anyway, even the perfect rates (95-98%) are nontrivially worse than perfect use of hormonal contraceptives (99.5%) and about the same as typical use of hormonals. (Not to mention that perfect condom use is 97% anyway and has the added bonus of STD protection.)
Yes, self-control is a tough sell these days. On that we agree.
But beyond the moral implications of "hormonal contraceptives," there are also serious health risks associated with the use of such birth control:
I don't have pregnancy data, but apparently, a study was done about STD rates among pledgers:
"Although not a controlled trial, one of the largest studies of the effect of abstinence pledges tracked the sex lives of 12,000 US teenagers aged between 12 and 18 (American Journal of Sociology, vol 106, p 859). A group led by Peter Bearman, a sociologist at Columbia University in New York, investigated whether taking a virginity pledge affected the age when people first had sex. It did, with an average delay of 18 months. The pledgers also got married earlier and had fewer partners overall.
But when Bearman went back six years later and looked at the STD rates in the same people, now aged between 18 and 24, he was in for a surprise. In research presented at the National STD conference in Philadelphia last year, he found that though pledgers had had fewer sexual partners than non-pledgers, they were just as likely to have had an STD. And the reason? 'Pledgers use condoms less,' says Bearman. 'It's difficult to simultaneously imagine not intending to have sex and being contraceptively prepared.'"
Seems less than 100 percent effective to me...
Anyway, thanks for providing an object lesson in real time of what the Seattle Health Department is dealing with when it tries to present accurate information about birth control. The reason they tried to make the comparison between the effectiveness of condoms and the effectiveness of abstinece in the first place is because of the anti-birth control crowd's misrepresentation of the data.
The site says that imperfect use of condoms is 86% effective-- ie very comparable to imperfect use of NFP. The "perfect" rates are also similar. While more effective, hormonal treatments also have more side effects.
Of course, it's entirely possible that there's a selection bias at work. Girls who would agree to take a virginity pledge may have already been inclined to delay or abstain from sex, even without the pledge. They may have had different behavior than non-pledgers with regard to birth control, STDs, etc. even if they had never been asked or agreed to take a pledge. But, taken for what they're worth, the numbers still support the conclusion that abstinence, as typically practiced, is not perfect protection.
I do oppose hormonal contraceptives, but I hardly see why that means I am "someone against effective birth control in general, rather than someone in favor of broadening knowledge about of all kinds of birth control."
As I've already demonstrated, NFP is effective if used properly, and I am all in favor of women being informed of the dangers of the "effective birth control" you seem to embrace.
I would also be interested in you explaining to the readers of VC exactly what you mean by "the anti-birth control crowd's misrepresentation of the data." I assume you have data/references to back up this claim, right? Or are you just parroting Planned Parenthood talking points?
I really can't stand to debate people who are against effective birth control, yet are almost certainly anti-abortion too. Ugh.
Oh yes, heaven forbid that you might actually have to defend the culture of death you promote/embrace (not that it's possible to do so).
And yes, I am pro-life. I believe in defending the most helpless/defenseless amongst us. I believe that if a woman chooses to have sex, then she ought to face up to the consequences of her actions (and so should the man as well). And in cases of rape and incest, I don't believe that an unborn baby should be put to death for the sins of the perpetrators of those actions.
And that makes me a monster, right?
Whatever. You are obviously incapable of defending your views, so I'll let you slink away.
Oh, and before you ask, yes I do oppose the death penalty.
If you're going to accuse those who endorse the safety of hormonal contraceptives of "parroting Planned Parenthood talking points," I would appreciate seeing some data from you that aren't from Christian organizations explictly opposed to the use of medical methods of preventing pregnancy.
The data on hormonal contraceptives do indeed state that there are risks, as there are with any medication. For example, acetaminophen, the main ingredient in Tylenol, is associated with liver, renal, and gastrointestinal toxicity that leads to as many as 100 annual deaths and 56,000 annual emergency room visits. All drugs have risks, and so the question is how prevalent are those risks, and how do they measure up to the benefits or harms prevented. With modern hormonal contraceptives, the risks are negligible. The risk of death or serious injury from pregnancy is significantly more statistically significant than the risk of taking the pill, even over the course of many years.
From the Food and Drug Administration:
If you would like to dig up some peer-reviewed data from an unbiased source on the statistical incidence of the birth control risks you noted, I would be happy to read them. Until then, I think I'll continue to take the advice of the numerous medical organizations that have endorsed the use of hormonal contraceptives.
Sure. Here are some non-Christian and/or peer-reviewed sources that you might find of interest:
If you'd like some more, I can provide them.
And here's a question for you: Why is that so many people who eschew the artificial in favor of the all-natural in virtually every other area of their life—e.g., food, clothes, etc.—are unwilling to extend that mentality to birth control. I find that fascinating, don't you?
Brilliant, I say.
O.k., let's say that he is. So what? I notice that you fail to address the other links I reference. Care to take those on, or is this a one shot hit-and-run rejoinder?
I don't know, why is it that people are willing to use artificial means of removing dirt from their homes, or curing infection, or alleviating pain? Come to think of it, why are people willing to use artificial means of communication, like computers, instead of relying on all-natural methods like a town crier or two tin cans strung together?
I jest, yes, but honestly, I find the "all-natural" crowd sort of bizarre myself. I don't understand why a person wouldn't want to wear comfortable synthetic fabrics or eat tasty, healthful food grown with the aid of chemicals any more than I understand why people would eschew safe, effective, convenient birth control. I simply don't understand the mindset that altering my own behavior to fit the natural world is somehow superior to or safer than altering the natural world to fit the choices I want to make in my life.
On the sources you provided. The first gives no information about the likelihood of the risks occurring; the data I'm reading state that the risks are extremely low for healthy women under 40. Do you have any actual numbers on the incidence of such problems? The second cites studies of women who took the pill in 1986 or before. The pill women take today has much lower doses of hormones than the pill from 20+ years ago, and thus the risks are believed to be negligible. The third source, once again, states that the risks are extremely low for healthy younger women. The fourth source does call into question the risks for long term use of Depo-Provera, the birth control shot. I assume, however, that women can talk with their doctors about the risks that are, per the FDA's mandate, clearly listed on the packaging, and decide for themselves whether they believe their health is jeopardized. Finally, your last source is again a study of women who used the higher-dose pill that has largely been phased out in favor of lower hormone pills. It also states that "10 years or more after they stopped using OCs, their risk of developing breast cancer returned to the same level as if they had never used birth control pills," which is why many doctors do not recommend the pill for women over 35 or 40, as most breast cancers develop at least a decade after that age. So all in all, I find no really compelling evidence in the sources you've provided that hormonal contraceptives pose a high risk to most women who use them.
I hope that women are talking to their doctors about the relative risks and benefits of any medications they are taking. I hope that men, women, and couples are considering all of their options and making informed decisions about what is right for them in their lives. Not every option is right for every person, and I'm glad that you've given so much thought and research to what is right for you in your life. However, you quoted (and therefore, I assume, endorsed) a very strong claim that, "Unethical doctors continue to become wealthy prescribing contraceptives and then treating the side effects." You've provided no evidence that doctors are withholding information from their patients, or that profit motives are getting in the way of responsible medicine, or that hormonal contraceptives pose a significant risk to most healthy women. I would urge you to really be certain of your evidence before making such extreme accusations.
And there's a lot more references if you're truly interested.
This would be like someone going on the pill for a couple months, then missing a couple days, having sex anyway, and never bothering to take it again. You'd hardly continue to count suck a person torwards the effectiveness of the pill.
Re: NFP, it is rather effective at preventing pregnancy, but it takes a bit of effort and self control (or a supply of alternate birth control for a portion of the cycle). Lots of women do end up with side effects on the pill (weight gain, loss of libido, etc), and NFP can be a good alternative. It isn't much for preventing STDs, of course, but neither is the pill.
Toni Weschler has a great book called Taking Charge of your Fertility which explains how to do it without a lot of the moralizing you get in other books on the topic.
Of course, that was supposed to say "count such a person".
Why do we always catch those things in the millisecond afrer we hit send, before the page refreshes?
The FDA link you provide in your second list of links is, amusingly enough, the same FDA link I provided in my original post to you. If you read past the title, you'll find this:
All of the University links in your second post note that the serious side effects are "very rare." Can you provide data showing that birth control is significantly more risky than Tylenol? More risky than driving a car every day? More risky than pregnancy and giving birth? If not, what you're arguing isn't that the pill is objectively seriously dangerous. Rather, you're arguing that, based on your own subjective valuation of risk and benefit, the slight risks of blood clots, compromised fertility, and certain cancers are not worth the convenience, protection from pregnancy, lower risk of certain other cancers, and other health benefits of taking the pill. Luckily, no one is forcing you to ignore your own valuation of those risks and benefits. All we're asking is that you not attempt to force those of us who disagree with you to ignore our judgement when it comes to our health.
You once again presume that if one is against hormonal contraceptives then he is automatically "against women's health." That's sheer nonsense. As is this silly statement:
I believe NFP is the best method for a woman's health. Am I not permitted to hold this position?
Amy-
Thank you for the thoughtful response. And we certainly agree that women should be "talking to their doctors about the relative risks and benefits of any medications they are taking, and that "men, women, and couples [should be] considering all of their options and making informed decisions about what is right for them in their lives."
I pray that more people will choose NFP, but I realize that many aren't willing to make that sacrifice.
As for this statement:
I wasn't necessarily endorsing it. That having been said, the vast majority of woman that I (and my wife) have spoken to about birth control have no clue about the side effects (such as they are). Indeed, before I converted to Catholicism, neither I nor my wife had any idea about the moral implications and health risks associated with birth control. I realize this is just my life experience (and not a formal study), but I strongly suspect that my wife and I were not in the minority re: our lack of knowledge about birth control.
Too funny. I thought that article looked familiar. :)
And yes, I am arguing that "based on [my] own subjective valuation of risk and benefit, the slight risks of blood clots, compromised fertility, and certain cancers are not worth the convenience, protection from pregnancy, lower risk of certain other cancers, and other health benefits of taking the pill."
I also strongly oppose hormonal contraceptives on moral grounds.
But I don't think I've said anything to suggest that I am "attempt[ing] to force those . . . who disagree with [me] to ignore [your] judgement when it comes to [your] health."
I am merely presenting an alternative view.
My wife was asked those questions as well, but her doctors (in the past) did not go over (verbally) the potential side effects of the pill or patch. As for the boilerplate prescription information, I think you and I are in a distinct minority (I read them as well). :)
I guess my overarching point is that many women take birth control without having really considered all of their options. It's become a right of passage of sorts, and I just think more woman ought to critically examine the issue rather than blindly pop that pill every day.
What about advocating safer practices, such as sex within a marriage, or total abstinence. Does that not fall under caring for women's health?
As a woman, who cares very much for women's health, I support abstinence education. I think we have failed our children by promoting "safe sex" just because of the "they're going to do it anyway" reasoning. Birth control is given out at adolescent clinics all the time, yet the girls keep coming back pregnant. Sometimes the daily pill is just "hard to remember." Perhaps the problem is children too young to be responsible enough to take a pill or use a condom are having sex. Maybe we should be encouraging them from a young age to respect themselves and abstain.
I am only a few months away from an MD. I, and many of my colleagues, have decided not to prescribe birth control. Many physicians don't feel comfortable with the possibility of post-fertilization effects of the pill. Also, I'm not sure I feel comfortable treating a healthy patient with hormones. Yes, other drugs have side effects as well, but they are used to treat real medical problems. Fertility is not a disease, so why treat it as one by prescribing something that has some significant risks. And as far as the protection against ovarian cancer, etc, pregnancy offers the same protection as the pill.
Anyway, I only wanted to say that it is possible to care significantly about women and not be pro-birth control or pro-abortion.
And then there's your statement about ovarian cancer: "pregnancy offers the same protection as the pill." This is a classic anti-birth controller nonsequitur. What, so should we all go get pregnant now to lower our ovarian cancer risk? We're chosing between methods of birth control, not between using birth control and getting pregnant. What that point of view really suggests is hostility towards effective birth control in general.
And your point about abstinence education is irrelevant -- we're talking about adult women here.
By the way, are you going to disclose to your patients up front that you refuse to prescribe the pill?
Men are sex pigs and contraceptives have made us more piggish.
"Another effect that gives cause for alarm is that a man who grows accustomed to the use of contraceptive methods may forget the reverence due to a woman, and, disregarding her physical and emotional equilibrium, reduce her to being a mere instrument for the satisfaction of his own desires, no longer considering her as his partner whom he should surround with care and affection." #17 from Hunanae Vitae
I understand that alternatives to the pill exist, but they still offer the same fundamental problem as OCPs. They are all treating the non-disease fertility.
And no, people should not get pregnant just to prevent ovarian cancer. I hope that you don't think that I believe that. Sometimes I feel that when OCPs are praised for their benefits such as reducing cancer risks, it is overlooked that pregnancy does the same thing. OCPs are not the only way to reduce risk. My point was only that I think it is important for people to know that if they choose to have children they also are getting that same benefit.
Yes, my patients will know my position. I am sure my future patients will be glad to know you were concerned. I will educate them as to their options, but they will know that I don't prescribe contraceptives and why. A patient is always free to choose to go elsewhere.
Unless you are being deliberately coy, I think you are understating things a bit here, aren't you? The lay public don't just have an idle curiosity, they are obligated under pain of criminal or civil penalty to follow the law. Is the law what it means in English or some meaning known only to some high priesthood?
Oh, and BTW post-ovulatory NFP has lower theoretical and actual failure rates than either the pill or the IUD. Ya' can't get a baby out of a dead egg!
cathy :-)
And characterizing fertility as "not a disease" does not add much to the conversation. Reproduction is a physical process humans have always been keenly interested in regulating, which is the essence of medicine.
Fine, Cathy, when you get into legal trouble get your car mechanic to represent you, instead of a lawyer, a member of the dreaded "high priesthood."
I really disagree with Eugene here -- the job of lawyers is not to dumb down the law itself, but rather to explain what the law means to the lay person. That's a completely different exercise.
Also, "actual malice" still bothers me after three years of law school, including a First Amendment class and the bar -- it's hard not to read the words with their everyday meaning : )
A comment on a subsequent comment:
"If you really cared about women's health you'd be advocating for safer contraceptives or promoting condom use."
I'm an adult woman who's abstinent (and will be until marriage), and in addition to meaning there's a zero percent chance I'll get pregnant beforehand, I also figure that's pretty good for my health, since I have no risk of STD's (fairly well epidemic in this country) or any side effects or negative impacts on fertility from artificial birth control. Seems to me the nonnegative impact of abstinence on women's health is a good reason for people who care about women's health to advocate abstinence. (It's also good for men.) As for after marriage, I'm with Steve in that while I realize it's a common and legitimate choice for many women to use hormonal birth control, I would practice NFP and hope more couples will come to do the same.
I do not mind this change. I do think, however, that it is a reason to not hang much in arguments on "medical" opinion. If A wants to avoid, eg, AIDS, there are things to avoid. If A wants to shooot drugs intravenously and be the recipient of anal sex with multiple anonymous partners, A is asking a different sort of medical question. Similarly if A wants to avoid obesity there are things to be avoided. If A wants to avoid obesity but eat a two monster burgers and a large fry for lunch everday, A is once again asking a very different sort of question.
Medicine has become about preference satisfaction and this has made it impossible to settle disputes by relying on medicine (assuming it ever was possible)
I do believe that you are considering what you believe to be best for your patients, and I'm glad you're open to the possibility that they have a different opinion about what is best for them. I hope, however, that you will tell women before they make appointments with you that you do not prescribe hormonal birth control. Many people have health insurance that allots them only one checkup or gyn exam each year, and they cannot see a second doctor of the same kind unless they are diagnosed with a problem. Women without health insurance must pay the costs of each visit out of pocket, and may not be able to afford to see two doctors. If one of these women makes an appointment with you and then finds out only afterwards that she cannot get birth control from you, it may cost her hundreds of dollars to see another doctor.
I'm all in favor of doctors using their best medical judgements, and I respect your right to decline to provide certain treatments, but I hope you will instruct your receptionist to inform every female patient who calls you that you are refusing to provide certain types of standard medical care before she makes an appointment.
So you are telling me that it's perfectly fine to need to hire lawyers to accompany each member of my family 24x7 to continuously scrutinize our behavior and explain to us when we are about to violate some statute which we couldn't possibly understand? I figure that's 16 lawyers (4 members of my family, 168 hours in a 7-day week). No, better make that 17 or 18 because we need some floaters to cover sick days and vacation... Yikes! My minivan only has 7 seat belts. What happens if buried in that mass of incomprehensible-to-the-lay-person verbiage there is some law which requires every rider in a car to be in a seat belt?
Gee, don't you think that it would be easier to have competent writers write laws so that people would be able to know, without needing to hire a lawyer to explain it, that they are required to wear seatbelts, or required to file their tax returns on April 15th, or any of the myriad things which they are required to do or prohibited from doing?
cathy :-)
Cathy - I do think that more explanations of the law should be available in plain language, and I think that all high schools should offer classes educating students on their basic legal rights and responsibilities. But I don't think that lawyers or legislators should be constrained by those considerations from the outset.
I noticed a post from, like, hours ago when you were questioning why people would use "articificial" means to clean their homes, communicate, etc., but not to prevent pregnancy. You admitted being tongue-in-cheek, but I have an entirely serious and related question for you:
Why is it that people who use hormonal contraceptives fail to see the absurdity of going to a doctor to STOP a perfectly good system in their body from working properly? If any other system in your body stopped working as it should, you'd run -- not walk -- to the nearest doctor to get it working properly again. Respiratory system getting you down? Go to the doctor to check for pneumonia. Endocrine system on the blink? Better check for a tumor in that pituitary gland and do whatever surgery or therapy is necessary to fix it!
But when it comes to being responsible with sex, we go to the doctor and say "Doc, my reproductive system is working perfectly...can you break it?" And when someone who gives a damn points out all the risks of doing that (including recent findings about permanent loss of libido...not sure that has been brought up yet) you get angry and defensive? Huh?
At some point, hopefully before it is too late for them to have the children they've always planned to have...later...I hope that women who share your misconceptions (no pun) realize that the purpose of hormonal birth control isn't -- nor was it ever -- to benefit women. It was, and is, pushed on you to allow grown-up boys to continue getting all they want from their relationships with women without having to be men and accepting the responsibility that comes with sex. You are being used, whether you realize it or not, and whether your sex partner is willing to admit it or not. And while you keep injecting and/or swallowing chemicals to please those boys, threatening your health and libido, you risk one more thing: letting the window of your individual fertility slam shut without having the chance to have the child or children you'd planned for and hoped for. If this is not a concern, so be it. But if you're like a relative of mine and several of my friends, who contracepted through their 20s only to get to their 30s and find themselves unable to conceive, there will come a very bitter time in your life when you realize that what I've just said is completely true, and that you've been cheated out of motherhood by guys who think of you as nothing more than the human version of an electical outlet. Please think about it.
Seriously, abstinence, like any other birth control "method," has a failure rate because sometimes people "fail" to abstain. As others have shown, there are risks to abstinence (less condom use/higher STD rates for abstainers).
To be more accurate, perhaps everyone should use the term "abstinence pledge" instead of mere "abstinence" when comparing the risks and benefits of birth control methods. By adding the word "pledge," it's clear that we're accounting for the fact that some people will fail to abstain.
I don't believe I was being angry or defensive; I was attempting, in what I believe was a calm and rational matter, to counter arguments that I found flawed with evidence that the facts do not support those arguments. If responding to a claim with a counterclaim constitutes "get[ting] angry and defensive," I'm not sure how anyone is ever supposed to have a rational debate.
I disagree with your assertion that I am being used, mostly because I believe I am intelligent enough to decide for myself what is in my best interest even if that happens to coincide with the interests of my sexual partners. I also believe that most women are similarly well-situated to determine for themselves what is in their best interests. Plenty of women are equally interested in "getting all they want from their relationships with [men] without having to be [women] and accept the responsibility that comes with sex" if by being a man/woman you mean being a parent. You may judge their choices as incorrect or bad, but it seems quite presumptuous for you to decide that you are better equipped than they are to make those choices for them.
There are, I agree, very few medical instances in which we treat healthy people to alter for their convenience the ways their bodies work. A few I can think of off the top of my head are medications that people take to prevent unwanted sweating ("breaking" the body's natural cooling mechanisms), gastric bypass surgery ("breaking" the digestive system), and inducing labor in healthy pregnant women ("breaking" the natural birth process). Those may be controversial, but the point is that we do accept medical intervention to raise quality of life for people who don't like the way their bodies naturally respond. Similarly, I don't have any problem with people who wish to temporarily or permanently "break" their body's natural tendency to conceive a child when they are unwilling or unable to care for a child.
I don't at all think it's absurd for us to use the technology available to us to get what we want from life, up to and including modifications of our own bodies. I believe that by choosing a method of birth control that assures we will not get pregnant unless and until we want to does constitute "being responsible with sex" as I define it. You are welcome, of course, to use a different definition of "responsible" in your own life, but please don't denigrate the careful choices that other women have made about theirs.
I agree that if there are fertility risks attendant to the use of hormonal birth control, doctors should discuss those with their patients. However, the medical evidence I have reviewed and presented here seems to show that those fertility risks mostly stem from high-hormone birth control pills that were prescribed 20-50 years ago, and which have now fallen out of favor. Your anecdotes, while very poignant, do not prove a correlation, much less causation, between hormonal birth control and the fertility problems your friends experienced. If you have evidence of a statistically significant fertility risk or risk to future libido that can be conclusively linked to the use of the low-dose hormonal birth control methods currently in use, I'd be happy to review it.
Finally, I'd like to note that you've made a lot of assumptions about what I and other women want from our lives. As it happens, I do not want children, and so I would welcome a pill that ruined my future fertility. I plan to get permanently sterilized as soon as the method I have chosen has been in wide use long enough that I am reassured of its safety. The idea that "there will come a very bitter time in your life when you realize that what I've just said is completely true, and that you've been cheated out of motherhood by guys who think of you as nothing more than the human version of an electical outlet" assumes that I desire motherhood, and that I desire a particular sort of relationship with the men in my life that not all women want. I assure you, I have thought about what I want from my life, and children aren't a part of my plan. I think it might be helpful in future discussions for us all to refrain from making assumptions that other people want what we want, and that we are therefore qualified to decide for them how best to pursue a happy life.
Thanks for your thoughtful response, but there's no need to worry about me. I know what I want, I've done my homework, and I've made the choices I think are best for me. It's admirable that you want to help other people make informed choices, but in order to do so, they need to get accurate information. I hope we can agree that women have the right to get the scientific facts about their reproductive health and make their own decisions based on that evidence and their own beliefs and desires.
I know that the failure rate of hormonal birth control includes pregnancies by women who use the pill as their primary birth control method, but who forgot to take it one or more times and then got pregnant. That's where the discrepancy between "perfect" and "typical" use occurs.
Given those methods of counting, it seems only fair that pregnancies among women who use abstinence as their method of birth control should be counted in the "typical" use of abstinence. After all, if I usually use condoms as my birth control, and I run out of them one night and, against my better judgement, agree to have unprotected sex, that counts as a condom failure. Why then, if I use abstinence as my birth control and my willpower slips one night and I agree, against my better judgement, to have sex, should that not count as an abstinence failure?
I am all for overruling Roe and Griswold with impunity because neither decision is even remotely supported by the text, history, and/or structure of the federal Constitution.
I also happen to personally oppose abortion in all cases, as well as all forms of artificial birth control (especially those that act as an abortifacient). But given how widely accepted birth control is these days, I think it's silly of you to be concerned about state laws being passed--upon Griswold being overturned--"banning all contraceptives." And even if a state were to enact such a ban, them's the breaks in a dual sovereignty system, sister. Just because you cherish your access to birth control doesn't make it a protected constitutional right.
Well, I thought my response made it pretty clear that I would support state laws banning contraceptives that act as an abortifacient. But in case there remains any doubt about my position, the answer is yes. I would most certainly favor prohibiting those types of contraception.
Let me explain this to you as simply as I can. The fact that one is personally opposed to abortion does not mean that person is also unable to likewise argue that the holding of Roe v. Wade is not supported by the text, history, and structure of the Constitution. My personal feelings re: abortion have no bearing on the merits of any constitutional challenge I might make with regard to Roe. I realize that you are unable to separate your personal feelings from constitutional analysis, but that doesn't mean that others are unable to do so.
BTW, and FWIW, there are many proabortion folks who think Roe was wrong decided.
A-C-T-I-V-I-S-T jurisprude.
Of course, you're not a big fan of originalism or textualism, now are you? Because if the Supremes actually interpreted the Constitution, rather than creating new "rights" out of wholecloth, you'd actually have to persuade your fellow citizens in the legislative arena to sign on to your hedonistic agenda. And why do that when you can ram it down out throats by judicial fiat, right?
Anyway, so what I hear you agreeing to is that your mandate to promote the Culture of Life ends at the courthouse doors?
Roe v. Wade, is, aside from any political ramifications, one of the most atrociously reasoned Supreme Court decisions in our history. There is little argument among serious legal scholars that the majority decision, such as it was, is legally and logically unsound.
That being said, Griswold is a poor decision, too. It creates, of whole cloth, a right to privacy which simply does not exist in the Constitution. I believe that we should have a right to privacy under certain circumstances (and the 4th Amendment outlines those instances); I just disagree with the Supreme Court creating one out of thin air.
Frankly, if Roe were repealed, most states would still allow abortions under some circumstances (most likely restrictions on the term of the pregnancy). Some might ban abortions entirely while others would allow them under all circumstances -- that is part of the way federalism is supposed to work.
As to contraception, I doubt any state would ban contraception. I strongly suspect that some states would prohibit distribution to individuals under a certain age, but they would not ban them. Contraception is too widely accepted and used for an outright ban to have any political support whatsoever.
I am curious, though -- if you support Roe strongly, do you similarly support the outcome in Bush v. Gore? Or are you one of those folks that only supports Supreme Court decisions which agree with your personal political predilections?
What you're hearing is that as a judge I would not impose my personal beliefs by judicial fiat. The role of a judge is to interpret the law, and nothing more.
Now, if I were king (or even president) then you'd be quite unhappy, but sadly that's not likely to happen.
My doctors won’t tie my tubes or take out my uterus. Why? Because they are using their “best medical judgment.” They pat me on my head and tell me not to worry. I’ll change my mind.
I am a married woman. I have gone to college and studied biochemistry. I’ve done my homework and I’ve accepted the risks.
And my doctors refuse to let me take responsibility for my actions.
I wish doctors were less paternalistic. What is better? Birth control or an abortion? Because the rhythm method won’t work in my case. Without birth control, my cycle is completely erratic, and I often bleed for a month at a time.
Should I have never married? Should I punish my husband by taking his wife away from him for nine months at a time while I deal with mental illness? Or should I have an abortion?
I think that this is a problem of doctors assuming the job of common sense for their patients. Yes, some women don’t think. They pop the pill and they don’t even bother to ponder the consequences. It’s a shame, but it’s *Their* problem.
When you do their thinking for them you punish the women who *do* think, who study and do their homework. No, I am not a doctor, but I think I should have the right to take the risks and the consequences for my actions.
Shame on you for patronizing women and not allowing them that basic right!